Dental Insurance
Types of Dental Insurance
Dental insurance in the 2000s comes in three basic types, each differing in the availability of providers and the form of payment to the provider.
Indemnity Plans: These plans are the traditional dental insurance plans which have been available since the 1950s. Patients can usually go to the dentist of their choice, and the dentist is paid only for the services provided; therefore, the patient has complete control of the treatment plan. The dentist provider ends up being paid the UCR (usual, customary, and reasonable) fee or a percentage of the UCR fee, with the patient paying the co-payment, or the portion of the fee not paid by the insurance company. These plans usually have the best benefits and cover the largest range of dental services.
Preferred Provider Plans (PPO):These plans feature a contract between the insurance company and the dentist provider to provide specific dental services. The fee paid to the dentist provider is usually lower than the UCR fee, and the patient may or may not have co-payments. The choice of dentist providers is limited to those providers who actually sign a contract, and many times specific services may be downgraded because of the benefits offered.
Dental Health Maintenance Organizations (DHMO): These plans mimic medical HMOs in that the services are prepaid. Patients have specific benefits which can be performed during the period the patient is covered under the DHMO. Co-payments may or may not be paid to the dentist provider. Traditionally this type of dental plan has the fewest number of covered services and the most restricted number of dentist providers.
Choosing a dental insurance plan
It can sometimes be difficult to choose a dental insurance plan for yourself and your family. Factors include the following: The range of dental benefits desired, the providers available, the fees or the percentages of the fees covered by the insurance, the deductible, the maximum benefit per benefit year, and the waiting periods if anyfor specific services. Another consideration about PPOs: Many of them will allow the patient to visit the dentist of his choice and although there is no contract, the insurance company will pay the non-preferred dentist provider from a table of allowances.
Our practice is a fee-for-service practice which means that we accept all indemnity plans and is a non-preferred dentist provider for the PPOs plan.